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 Up Front With Martin B. Deutsch

martin FIT AND FATAL?

BY MARTIN B. DEUTSCH

October 1, 1986 -- Heresy. Or is my hearing impaired, too? I couldn’t believe my ears, but the radio doesn’t lie, does it? The words that inspired my disbelief were these:

"Conventional wisdom and a good deal of medical opinion notwithstanding, he contends that vigorous exercise is not needed to achieve and maintain cardiovascular health…"

The familiar voice was that of Mel Grannick, who has a weekday feature on CBS radio called "Report on Medicine." The "he" Grannick was interviewing is Dr. Henry Solomon, a clinical assistant professor of medicine and cardiology at the New York Hospital/Cornell Medical Center. (You can also get current on Dr. Solomon’s apostasy in a book called The Exercise Myth, in which he contends that the advantages of vigorous physical activity have been oversold, in large measure by those profiting from the sale.)

The central theme of Dr. Solomon’s controversial position, as expressed during the five days his views were aired, is this: "We have all assumed, and we’ve been sort of led to believe, that health and fitness are the same thing. They are not. Fitness refers to your capacity to do physical activity, and health refers to the presence or absence of disease."

He goes on: "You can be very fit and very unhealthy. Indeed you can be extremely fit and totally ill. Imminently going to die. And you would not know it until death struck."

Dr. Solomon cites studies that indicated that some cardiac death is far more likely during strenuous exercise than during sedentary activity.

Hey, what’s going on here? Are we the victims of some vast scam? A commercial conspiracy? When it’s time to hit my exercycle or launch into my Canadian Air Force program what should I do? Proceed as programmed or lie down until the urge passes? How about when I’m on the road, where I try religiously to do something at least every other day to keep the old heart muscle pumped up? Am I wasting my time, am I courting sudden disaster?

Dr. Solomon, for one, believes that little more than a brisk daily one-mile walk is called for. "What you need is a little bit of moderate exercises every day to eliminate the risk of doing nothing," he says. "There is a small risk to being very sedentary. But you really have to be what I call a slug, who does nothing, to be at any risk."

The good doctor feels rather strongly on the subject. He is quoted from his book The Exercise Myth as describing the current popularity of strenuous activity to achieve a better health as "a folly and a danger."

"The problem that exercise really endangers is sudden death…And we have very little we can do about it. And that is the very kind of problems that is seriously provoked by exercise." He alludes to one study that found that cardiac death occurs seven to nine times more frequently during intense exercise than during a sedentary period.

Nor is Dr. Solomon isolated in his outlook. The radiocast also brings in Dr. Albert Oberman, a member of the American Heart Association’s subcommittee on information about exercise has come from people who have a vested interest in exercise is a panacea for everything that ails us.

"And certainly that’s not true," Dr. Oberman adds. However, Dr. Oberman qualifies his comments by explaining that there are benefits to be gained from exercise. But that the question of how much or how strenuous it must be in order to get the benefits is a controversial one. Dr. Oberman, who heads the division of general and preventive medicine at the University of Alabama, Birmingham, also feels it somewhat makes sense to exercise and keep your body "somewhat" in shape.

He also takes issue wit Dr. Solomon’s conclusions on the greater frequency of cardiac deaths during exercise. He says the study Dr. Solomon cites doesn’t tell the whole story. "Most people who die of heart disease…usually end up having a fair amount of coronary disease. And it’s usually not the story of someone who’s completely normal and if he hasn’t exercised or exerted himself he would have died." Further, Oberman refers to studies indicating that when people who are physically active do have heart attacks, they tend to survive them more than people who are not physically active.

Dr. Oberman also discusses the "pretty good evidence" that fairly vigorous exercise has beneficial influence on such factors as blood pressure, metabolism, and the amount of oxygen the heart needs for any given quantity of work.

A final word or two from Dr. Solomon to cast uncertainty in concrete. "The primary risk factors that we recognize for coronary heart disease: high blood pressure, cigarette smoking and high cholesterol, as well as an inherited family history or hearth disease; these things are very poorly altered by exercise." And: "Your heart whether you want it to or not, will beat between 80,000 and 100,000 times in the next twenty-four hours. Now, I submit to you that that’s work…the heart is a working muscle all the time. It does not need the boost."

If you’ve controlled your palpitations while reading this, drop me a note and tell me how you feel about it.

This column originally appeared in Frequent Flyer magazine.

Copyright © 1991-2007 by Martin B. Deutsch. All rights reserved.